Assist the client in developing calendars or lists to record the details of scheduled activities and obligations; ask him/her/them to keep the list with him/her/them always and mark off each item as it is completed.
Assign homework asking the client to accomplish identified tasks without procrastination using the techniques learned in therapy (or supplement with “Self-Monitoring/Self-Reward Program” in the Adult Psychotherapy Homework Planner by Jongsma & Bruce); review and provide corrective feedback toward improving the skill and decreasing procrastination.
Create and utilize an environment free from distracting stimuli that can be used for productive learning. (46)
Use a stimulus control approach to help the client design and implement an environment free of extraneous stimulation and serve as a place of study, concentration, and learning; explore the client's interest in using positive reinforcements after successful work sessions.
Combine skills learned in therapy into a new daily approach to managing ADHD. (47, 48, 49)
Teach the client mediational and self-control strategies (e.g. “stop, look, listen, and think”) to delay the need for instant gratification and inhibit impulses toward achieving more meaningful, longer-term goals (or supplement with “From Recklessness to Calculated Risks” in the Addiction Treatment Homework Planner by Lenz, Finley, & Jongsma).
Select situations in which the client will be increasingly challenged to apply his/her/their new strategies for managing ADHD, starting with situations in which the client is highly likely to be successful (or supplement with “Problem Solving: An Alternative to Impulsive Action” in the Adult Psychotherapy Homework Planner by Jongsma & Bruce).
Use techniques such as imagery, behavioral rehearsal, modeling, role-playing, and/or in vivo exposure/behavioral experiments to help the client consolidate the use of his/her/their new ADHD management skills.
Implement less impulsive social skills to minimize intrusions and offending others. (50, 51, 52, 53)
Use instruction, modeling, and role-playing to build the client's general social and/or communication skills (see What Does Everybody Else Know That I Don't? Social Skills Help for Adults with Attention Deficit/Hyperactivity Disorder by Novotni & Peterson).
Assign the client to read about general social and/or communication skills in books or treatment manuals on building social skills (e.g. Your Perfect Right by Alberti & Emmons; Conversationally Speaking by Garner).
Review social situations in which the client was intrusive or talked excessively without thoughtfulness; using modeling, role-playing, and instruction to teach alternatives that are more likely to be interpersonally effective.
Teach the client problem-solving techniques that require thought before taking action and apply to simulated and actual interpersonal conflict situations (or supplement with “Applying Problem Solving to Interpersonal Conflict” in the Adult Psychotherapy Homework Planner by Jongsma & Bruce or “Staying Attentive and Other Negotiating Skills” in the Addiction Treatment Homework Planner by Lenz, Finley, & Jongsma).
Learn and implement calming skills to reduce tension, restlessness, and the risk of impulsive actions. (54)
Teach the client general and acute calming and relaxation skills; use modeling and behavior rehearsal toward decreasing tension and impulsive actions (or supplement with “Self-Soothing: Calm Down, Slow Down” in the Addiction Treatment Homework Planner by Lenz, Finley, & Jongsma).
List coping skills that will be used to manage ADHD symptoms. (55)
Review with the client the symptoms that have been problematic and the newly learned coping skills he/she/they will use to manage the symptoms (or supplement with “Symptoms and Fixes for ADD [now ADHD]” in the Adult Psychotherapy Homework Planner by Jongsma & Bruce).
Learn and practice mindful meditation to enhance attentional focus. (56)
Explain a rationale and teach the client mindful meditation to enhance attention regulation; apply the skill in other tasks requiring attentional focus within the client's limitations.
Develop an aftercare program that includes regular attendance at recovery group meetings, getting a sponsor, and continuing the therapy necessary to bring ADHD and addiction under control. (57)
Help the client develop an aftercare program that includes regular attendance at recovery group meetings, getting a sponsor, and continuing
